At-home COVID-19 Test Kits Covered by Insurance

On January 10th, the Biden administration mandated that group health plans cover over-the-counter (OTC) COVID-19 tests for diagnostic purposes. You do not need a doctor to prescribe these at‑home tests. The mandate takes effect on January 15th and stipulates that there be no member cost share or copays when purchasing an OTC test.

NOTE: Coverage may be limited to $12 per test or the cost of the test, if lower, if you do not use a network provider. Check with your insurer for network information.

In addition to the eight tests covered by insurance, the federal government has also made four OTC tests per home available, for delivery through the United States Postal Service, at https://www.covidtests.gov/.

Check below for information regarding your coverage based on your Union affiliation:

Philadelphia Federation of Teachers (PFT)

Test kits will be covered using your prescription card through Capital RX.   Please check with the Philadelphia Federation of Teachers (PFT) Health and Welfare Fund for information.

For reimbursement, members must submit the completed CapitalRX-Direct Reimbursement form along with:

  • A photo of the purchased COVID-19 test kit box with barcode visible
  • Receipt of purchase that displays the date and the purchased item highlighted/circled

Local 634 Unite Here!

Test kits will be covered using your prescription card from Benecard. Please check with the BeneCard Prescription Benefit Facilitator at 1-888-907-0070 TDD: 1-888-907-0020 for more information.

If you purchased tests on or after January 15, 2022, use this form for reimbursement.

District 1201 / 32BJ

The 32BJ members can use their OptumRx pharmacy card to purchase up to EIGHT at-home COVID-19 tests per month per person in your household with $0 copay. If your pharmacy is unable to get you the tests using the OptumRx pharmacy card, buy the tests out of pocket and get reimbursed through your pharmacy benefit with OptumRx.  For more details, and to submit the form for reimbursement, go to: optumrx.com/testinfo.

Commonwealth Assoc of School Administrators (CASA)

Use your drug coverage to get your test kits at Rite Aid, Walmart, or Sam’s Club pharmacy counters, using your pharmacy benefits.  By using Rite Aid, Walmart, or Sam’s Club members won’t need to pay for the tests.  You present you Keystone or Personals Choice member ID card at the pharmacy counter to have their test kit(s) processed through the pharmacy benefit.  If you purchase tests from other in‑store or online retailers (outside of Rite Aid, Walmart, or Sam’s Club); you will need to submit a pharmacy claim form with receipt to FutureScripts/Optum for reimbursement. You will be reimbursed for the cost you paid for the test or $12 per test, whichever amount is lower.

School Police Association of Philadelphia (SPAP)

Use your drug coverage to get your test kits at Walgreens, Rite Aid, Walmart, or Sam’s Club pharmacy counters, using your pharmacy benefits.  By using Rite Aid, Walmart, or Sam’s Club members won’t need to pay for the tests.  You present you Keystone or Personals Choice member ID card at the pharmacy counter to have their test kit(s) processed through the pharmacy benefit.  If you purchase tests from other in‑store or online retailers (outside of Rite Aid, Walmart, or Sam’s Club); you will need to submit a pharmacy claim form with receipt to FutureScripts/Optum for reimbursement. You will be reimbursed for the cost you paid for the test or $12 per test, whichever amount is lower.

Non Represented Employees

Use your drug coverage to get your test kits at Walgreens, Rite Aid, Walmart, or Sam’s Club pharmacy counters, using your pharmacy benefits.  By using Rite Aid, Walmart, or Sam’s Club members won’t need to pay for the tests.  You present you Keystone or Personals Choice member ID card at the pharmacy counter to have their test kit(s) processed through the pharmacy benefit.  If you purchase tests from other in‑store or online retailers (outside of Rite Aid, Walmart, or Sam’s Club); you will need to submit a pharmacy claim form with receipt to FutureScripts/Optum for reimbursement. You will be reimbursed for the cost you paid for the test or $12 per test, whichever amount is lower.